,i #aaith ,,congress #ast ,session ,h4 ,r4 #bajg ,,in ,,the ,,house ,,of ,,representatives ,march #ad1 #bjbe,mr4 ,crenshaw 7for himself1 ,mrs4 ,miller of ,illinois1 ,mrs4 ,miller-,meeks1 ,mr4 ,pfluger1 ,mr4 ,ellzey1 ,mr4 ,van ,drew1 ,mr4 ,green of ,tennessee1 ,mr4 ,rouzer1 ,mrs4 ,harshbarger1 ,mr4 ,grothman1 ,mr4 ,jackson of ,texas1 and ,mr4 ,scott ,franklin of ,florida7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend title ,,iii of the ,public ,health ,service ,act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,children's ,hospital ,,gme ,support ,reauthorization ,act of #bjbe4 #b4 ,program of payments to children's hospitals that operate graduate medical education programs ,section #cdj;,e of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bef;e7 is amended-- 7#a7 in subsection 7a71 by striking #bjbc and inserting #bjcj2 7#b7 in subsection 7b77#c77;,d71 by inserting and the end of fiscal year #bjcj1 after fiscal year #bjbb12 7#c7 in subsection 7e71 by adding at the end the following new paragraph3 7#d7 ,prohibition on payments to hospitals furnishing specified procedures and drugs to minors 7,a7 ,in general ,notwithstanding any other provision of this section1 no payment may be made under this section to a children's hospital for a fiscal year 7beginning with fiscal year #bjbf7 if1 at any point during the preceding fiscal year1 such hospital furnished specified procedures and drugs 7as defined in subsection 7g77 to an individual under #ah years of age4 7,b7 ,special rule for fiscal year #bjbf ,in applying subparagraph 7,a7 with respect to payments described in such subparagraph for fiscal year #bjbf-- 7i7 the reference to for a fiscal year shall be treated as a reference to for any portion of fiscal year #bjbf occurring after ,december #ca1 #bjbe2 and 7ii7 the reference to the preceding fiscal year shall be treated as a reference to the period beginning on ,september #a1 #bjbe1 and ending on ,december #ca1 #bjbe4 7,c7 ,rule of construction ,nothing in this paragraph shall be construed as prohibiting payments for a fiscal year 7or1 in the case of payments for fiscal year #bjbf1 during the portion of such fiscal year described in subparagraph 7,b77i77 to a hospital that1 during the preceding fiscal year 7or1 in the case of payments for fiscal year #bjbf1 during the period described in subparagraph 7,b77ii771 furnished mental or behavioral health services to individuals under #ah years of age for the treatment of gender dysphoria not consisting of specified procedures and drugs4 2 7#d7 in subsection 7f7-- 7,a7 in paragraph 7#a77;,a7-- 7i7 in clause 7v71 by striking and at the end2 7ii7 in clause 7vi71 by striking the period at the end and inserting 2 and2 and 7iii7 by adding at the end the following3 7vii7 for each of fiscal years #bjbf through #bjcj1 #abd1jjj1jjj4 2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,e71 by striking and at the end2 7ii7 in subparagraph 7,f71 by striking the period at the end and inserting 2 and2 and 7iii7 by adding at the end the following3 7,g7 for each of fiscal years #bjbf through #bjcj1 #bfa1jjj1jjj 2 and 7#e7 in subsection 7g71 by adding at the end the following new paragraph3 7#d7 ,specified procedures and drugs 7,a7 ,in general ,except as provided in subparagraph 7,b71 the term specified procedures and drugs means1 with respect to an individual1 any of the following3 7i7 ,performing any surgery for the purpose of changing the body of such individual to no longer correspond to the individual's sex1 including-- 7,i7 castration2 7,,ii7 orchiectomy2 7,,iii7 scrotoplasty2 7,,iv7 vasectomy2 7,v7 hysterectomy2 7,,vi7 oophorectomy2 7,,vii7 ovariectomy2 7,,viii7 metoidioplasty2 7,,ix7 penectomy2 7,x7 phalloplasty2 7,,xi7 vaginoplasty2 7,,xii7 vaginectomy2 7,,xiii7 vulvoplasty2 7,,xiv7 reduction thyrochondroplasty2 7,,xv7 chondrolaryngoplasty1 or any plastic surgery that feminizes or masculinizes the facial features2 7,,xvi7 mastectomy1 or any placement of chest implants to create feminine breasts2 and 7,,xvii7 ,any placement of fat or artificial implants in the gluteal region4 7ii7 ,administering1 supplying1 prescribing1 dispensing1 distributing1 or otherwise conveying to an individual medications for the purposes described in clause 7i71 including gonadotrophin releasing hormone 7,gn,r,h7 analogues or other puberty-blocking drugs to stop or delay normal puberty1 and estrogen1 testosterone1 progesterone1 or other androgens to an individual in an amount greater than would normally be produced endogenously in a healthy individual of that individual's age and sex4 7,b7 ,exception ,subparagraph 7,a7 shall not apply to the provision by a physician or health care provider1 with the consent of the child's parent or legal guardian1 of-- 7i7 puberty suppression or blocking prescription drugs for the purpose of normalizing puberty for a minor experiencing precocious puberty2 7ii7 appropriate and medically necessary procedures or treatments to correct for-- 7,i7 a medically verifiable genetic disorder of sex development1 including-- 7aa7 #df1,,xx chromosomes with virilization2 7bb7 #df1,,xy chromosomes with undervirilization2 and 7cc7 both ovarian and testicular tissue2 or 7,,ii7 sex chromosome structure1 sex steroid hormone production1 or sex hormone action1 if determined to be abnormal by a physician through genetic or biochemical testing2 7iii7 infection1 disease1 injury1 or disorder caused or exacerbated by previous medical procedures as defined in subsection 7g77#d77;,a72 or 7iv7 a physical disorder1 physical injury1 or physical illness that would1 as certified by a physician1 place the individual in imminent danger of death or impairment of a major bodily function unless the procedure is performed1 not including if the procedure or drug is for the purpose described in subsection 7g77#d77;,a77i74 7,c7 ,sex ,for purposes of subparagraph 7,a71 the term sex means the indication of male or female sex by reproductive potential or capacity1 sex chromosomes1 naturally occurring sex hormones1 gonads1 or internal or external genitalia present at birth4 4